Chammoun, Michael Stephen

Chammoun, Michael Stephen is an sole proprietor health care provider with primary practice located at 2310 N Patterson St Bldg D, Valdosta GA 31602-2568. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Chammoun, Michael Stephen can be contacted via phone (229) 247-2482.

Contact Information

Primary practice address
2310 N Patterson St Bldg D Valdosta GA 31602-2568
Phone: (229) 247-2482
Fax: (229) 247-0827
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 003153 Georgia

Profile Details

NPI number 1962404541
LBN Legal business name Chammoun, Michael Stephen
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2005
Last updated Mar 25th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962404541 NPPES
Georgia MEDICAID 100000805A

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